BronxCreed

Center Projects

Community Projects

Bronx Faith and Medicine

Research Core

Project funded for four years"LOS CAMINOS: DEVELOPING CULTURALLY-SENSITIVE PATHS TO DIABETES SELF-MANAGEMENT"The focus of this study is identifying barriers for prevention and early treatment of diabetic eye complications in the Hispanic population and to elucidate strategies that can be effective for a range of other self-management behaviors. Important themes identified in this study are: a) Lack of understanding about effective disease management, b) Inconsistent social support, c) Concerns about changes in sexual functioning since diagnosis, d) High incidence of depression, e) Lack of knowledge about diabetes, f) Lack of resources. The second phase of the research project uses the survey findings based on the review of the focus group data. Information is also being collected and analyzed from focus groups and now interviewing a larger multi-ethnic cohort of an earlier sample from the Vision is Precious (VIP) study.

Arlene Caban, PhDPrincipal Investigator

Elizabeth Walker, DNSc, RN, CDECo-Investigator

Pilot Study # 1 funded for two yearsIMPACT OF CORONARY HEART DISEASE (CHD) RISK PERCEPTION ON HEALTH BEHAVIORSAssesses the effect of risk perception of coronary heart disease on health-promoting behaviors among a socio-economically and ethnically diverse population, such as African Americans and Hispanics in the Bronx by testing a recently developed risk perception instrument for potential wide-spread clinical application. Overall knowledge of coronary risk factors was found to be sub-optimal with a low-to-moderate perception of personal risk of Coronary Heart Disease. Paradoxically, persons at highest risk of coronary disease were aware of their risk, yet engaged in more unhealthy behaviors.

Janice Barnhart, M.D., M.SPrincipal Investigator

Pilot Project #2 funded for two yearsCOMMUNITY HEALTH CENTER-BASED SCREENING PROGRAM FOR DIABETES MELLITUSThe prevalence of undiagnosed diabetes in patients attending a community health center is not known, nor has the feasibility of diabetes diagnosing screening methods been tested. The researchers obtained random capillary blood glucose that were done "on the spot" to screen for diabetes. The study found a median glucose of 96 mg/dl with 38% having a value 100 mg/dl. The prevalence of undiagnosed diabetes was very low (0.74%), and confirmatory testing among positive screenees was high. On the other hand acceptance of diabetes screening in this population was low with many individuals declining and often giving as a reason, "If I have diabetes, I don't want to know about it."

Pilot Project #3 funded for two yearsA FAMILY-ORIENTED MODEL OF COMMUNITY OUTREACH TO REDUCE DISPARITIES IN CARDIOVASCULAR & DIABETES MORBIDITY & MORTALITY IN THE SOUTH BRONXThe long-term aim of this project was to conduct a randomized clinical trial of the use of peer educators to provide family group education and support for people with high risk profiles for cardiovascular disease and diabetes. The "Peer Educators," or Promotores de la Salud, were adults, predominantly African-Americans and Latinos recruited from the South Bronx and given an extensive course in cardiovascular and diabetes related risk reduction. Family discussion groups led by peer educators were found to be feasible psycho-educational techniques to improve multiple risk factor reduction behavioral change, and improve knowledge among both patients and family members, reducing weight, depression and improvement in glucose levels among a majority of participants.

Chris NorwoodPrincipal Investigator

Alvin H. Strelnick, MDCo-Investigator

Pilot Project #4 funded for two yearsCARDIOVASCULAR MA RKERS IN OBESE MINORITY YOUTHThe relationships among obesity, blood pressure regulation and various biomarkers are not well defined in children. The hypothesis that adipocytokines (biomarkers of cardiovascular disease), in obese minority adolescents are associated with hypertension or early elimination of the normal nocturnal dip in BP, and alterations in glucose metabolism, and microalbuminuria will be studied by measuring levels of fat-derived peptides and cytokines (adiponectin, leptin, CRP, and PAI-1) in obese pubertal minority subjects and lean controls, speculating that those with abnormalities in blood pressure and/or glucose intolerance will have abnormalities in cardiovascular biomarkers.. Findings will be helpful in the development of pediatric criteria for the metabolic syndrome and will permit assessment of efficacy of therapeutic interventions. The study is targeted to involve 80 pubertal minority youth 10-18 years old predominantly female, African-American and or Hispanic.

Joan DiMartino-Nardi, MDPrincipal Investigator

Joseph Flynn, MDCo-Investigator

Katherine Freeman, DrPHCo-Investigator

Pilot project #5 funded for one yearRACIAL AND ECONOMIC DISPARITIES IN ACCESS TO NICOTINE REPLACEMENT THERAPY IN NEW YORK CITY PHARMACIESRace, ethnicity and socioeconomic status are predictors of tobacco use; a possible determinant of the different rates of smoking among minority groups is access to smoking cessation aids such as nicotine replacement therapy. Pharmacies in nonwhite neighborhoods are less likely to sell over-the-counter nicotine replacement products and may have more tobacco products displayed. The investigators will examine a random sample of New York City pharmacies including pharmacies located in supermarkets or affiliated with health care settings in order to assess the accessibility of nicotine replacement products in undeserved populations. The data will be used to improve future community-based interventions for lowering tobacco use.

Steven Bernstein, MDPrincipal Investigator

Lisa Cabral, MDCo-Investigator

Pilot project # 6 funded for one yearTHE IMPACT OF PHARMACEUTICAL SAMPLING OF MEDICATIONS FOR HYPERTENSION, DIABETES, AND HYPERCHOLESTEROLEMIA ON RACIAL DISPARITIES IN THE TREATMENT OF THESE CONDITIONSLong-term adherence to medications is important in the management of chronic diseases such as hypertension, diabetes and hypercholesterolemia. Distribution of medication samples by pharmaceutical representatives (drug detailing) may ease the economic barriers to treatment adherence, can improve relationships between physicians and patients, but can also lead to reliance on newer and more expensive medications. The investigators will examine the impact of distributing medication samples in primary care clinics and their impact on racial differences and adherence. They will survey clinic policies related to medication samples, obtain information of the number of medications provided, and assess physician and staff attitude towards the ability to accept and distribute samples. A secondary aim will be to study the impact of the availability of samples by assessing the number of brand vs. generic prescription generated, as well as the impact that samples have on chronic adherence.

Nancy Sohler, PhD, MPHPrincipal Investigator

Diane McKee, MDCo-Investigator

Pilot project # 7 funded for data analysisGAY, LESBIAN, AND BISEXUAL YOUTH SPEAK OUT TO PROVIDERS: UNDERSTANDING YOUTH PERSPECTIVES ON HEALTH CARE PROVIDERS AND HEALTH CARE SETTINGS IN ORDER TO IMPROVE QUALITY AND ACCESSThis is a project to elicit perspectives and experiences of health care provided to gay, lesbian, bisexual, and transgender individuals. The study obtains information about health care providers' attitudes, the settings in which they receive health care, and health concerns and issues. Funding is being used to complete an analysis of previously obtained surveys. The data will be used in the future to prepare a training curriculum for primary care providers in order to improve health care and health care access for this sub-population of youth.

Neal Hoffman, MDPrincipal Investigator

Kathy Freeman, DrPHCo-Investigator

Research Training Core

"Improving Health Literacy to Reduce Obesity in a Very Poor Urban Setting"Examines the effects of a health literacy intervention on reducing childhood and adult obesity among very poor inner-city residents. This project is funded by the Pfizer Health Literacy Program.

Iman Sharif, MD, MPHAssociate Professor of Pediatrics

"Understanding Stress Urinary Incontinence in Women"Examines whether different patterns of urinary incontinence seen in Black and White women are associated with alterations in urethral smooth muscle tonicity and/or proteins. Dr. Guess was recently awarded a minority supplement from Robert Wood Johnson to expand this area of research.

Childhodd AsthmaThis study uses a novel multi-dimensional CARAT scale (Children's Asthma Risk Assessment Tool) that she developed to determine risk factors associated with asthma morbidity in a national sample of inner-city children with persistent asthma.

Karen Warman, MDAssociate Professor of Pediatrics

Domestic Violence StudyPerforms analysis of the Mother-Infant Rapid intervention at Delivery (MIRIAD) database to determine factors associated with domestic violence in HIV positive women and women at high risk for HIV.